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Korean Journal of Clinical Oncology > Article
ORIGINAL ARTICLE
Korean J Clin Oncol. 2011;7(1): 52-59.         doi: https://doi.org/10.14216/kjco.11009
The Postoperative Outcomes of Patients with Primary, Secondary and Tertiary Hyperparathyroidism : 14 Year Experience of Seoul National University Hospital
Yun-Suk Choi1, Kyu Eun Lee2, Do Hoon Koo3, Eun Mee Oh2, June Young Choi2, Kwi-won Park1, Dong Young Noh1, Yeo-Kyu Youn2, Seung-Keun Oh2
1Department of Surgery, Seoul National University College of Medicine
2Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Thyroid Center, Seoul National University Cancer Hospital
3Department of Surgery, Seoul National University College of Medicine, Boramae Medical Center
일차성, 이차성 그리고 삼차성 부갑상선 기능 항진증 환자의 수술 후 임상결과 : 서울대학교 병원에서의 14년 경험
최윤석1, 이규언2, 구도훈3, 오은미2, 최준영2, 박귀원1, 노동영1, 윤여규2, 오승근2
1서울대학교 의과대학 외과학교실
2서울대학교병원 외과 서울대학교 암병원 갑상선센터, 서울대학교 의과대학 암연구소
3서울대학교 의과대학 외과학교실, 보라매병원
Corresponding Author: Seung-Keun Oh ,Tel: +82-2-2072-2325, Fax: +82-2-766-3975, Email: osk@snu.ac.kr
Received: May 23, 2011;  Accepted: June 20, 2011.
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ABSTRACT
Purpose : Primary hyperparathyroidism(PHPT), secondary hyperparathyroidism(SHPT) and tertiary hyperparathyroidism(THPT) are different in the cause, treatment and prognosis. However the parathyroidectomy has been an efficient treatment in all hyperparathyroidism groups. A single institution`s 14 year experience of surgical treatment was analyzed to investigate perioperative changes of clinical characteristics and reconsider the value of parathyroidectomy as the treatment option. Materials and Methods : From 1996 to 2009, 126 patients underwent parathyroidectomy at single institute and the number of patients with PHPT, SHPT and THPT were 96, 24 and 6 retrospectively. The electronic medical records of age, sex, biochemical analysis, operative method, and pathologic results were reviewed retrospectively. Results : Postoperative calcium (Ca), parathyroid hormone (PTH), ionized calcium (iCa) levels were improved definitely than preoperative Ca, PTH, iCa level in all three groups. Pre and postoperative PTH level in SHPT was higher than in PHPT and THPT(p< 0.001, p= 0.036) and postoperative persistent PTH increased status were more common in SHPT.(30.4%, p< 0.001) Postoperative temporary hypocalcemia was more common in SHPT(87.5%, p< 0.001), almost of them (90.4%) were recovered in 6 month. In SHPT group, temporary hypocalcemia were more common in subtotal or total parathyroidectomy group than in limited resection group (94.1%) but persistent iPTH increase were more common in limited resection group (50%). . Conclusion : Parathyroidectomy is highly recommended to improve biochemical laboratory findings in patients with hyperparathyroidism. And in SHPT, subtotal or total parathyroidectomy is more appropriate surgical method for reducing the high incidence of persistent hyperparathyroidism.
Keywords: Hyperparathyroidism | Persistent hyperaparathyroidism | Temporary hypocalcemia
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